the proposed location provides a platform for cpmc to expand existing programs and i see that their long-term engagement with us and are theses in the tenderloin will ensure that cpmc is attentive to community needs.

president miguel: jane martha. >> good afternoon, commissioners, joseph smith, coalition for health planning, san francisco. breaking down simply that cpmc has four campuses which are basically hospitals with associated services. what cpmc plans to do is phase out the california campus, concentrate outpatient services at their pacific campus and concentrate inpatient services at the new facility at van ness and geary on cathedral hill. the description of st. luke's, however, in the project plan, focuses on a new medical building and a new hospital building that is significantly smaller than the existing hospital. what we see in the d.i.r. is that there is no vision for st. luke's, no anchor.

functionally, it reads as though it is an access point for specialty services provided at cathedral hill or pacific campus. st. luke's operated as a full-service hospital primarily providing charity care for well over 100 years until sudder health took over. st. luke's, this takeover happened a few years ago. instead of using its financial strength to build on the tradition of charity care, sutter and cpmc have been systematically dismantling the charity care that's existed at st. luke's. we're asking that the e.i.r. study the alternative or an alternative to what's presented as alternative 3a., the reason is that there was a demand of the community for st. luke's to stay open and what we're seeing is that there are signs there will be continued dismantling of

the charity care and commitment to the southeast neighborhoods and the care that's necessary in those neighborhoods by cpmc. what alternative 3a. does, it shifts services and beds from other campuses to, instead of everything going to the inpatient facility on cathedral hill, that some of those beds would be shifted to st. luke's. what we don't like is they're just women's and children's services. a lot of those services need to be dispersed throughout the neighborhoods of san francisco. we want to see not just a dispersing of services that are equitable and accessible in different communities throughout the city but also there be an anchor that's more of an emergency department and women's and children's services at st. luke's. there needs to be a vision around st. luke's because we don't trust it will be open. we needed to create a blue ribbon panel to keep it open and

before that panel, sutter said they would keep it open and after the panel, they admitted they intended to close it. we want to make sure it's a viable hospital for the future. [applause] president miguel: thank you. >> my name is jane marn, i'm with the california nurse's association and on the board that's a member for the coalition of healthcare planning. there's a huge problem with the environmental impact report and that's that it fails to analyze the healthcare applications of the plan. we support the primarily better alternative with a clinical anchor. that is environmental superior in terms of traffic in the analysis that's done and better for healthcare. the e.i.r. does not analyze the burden on city services for the services cpmc will no longer provide. cpmc has closed over 70% of

psychiatric services despite a growing need for those services and instead those psyche patients are shifted to other providers. cpmc plans to close long-term care for the disabled and elderly. all of these would impact on the city's healthcare system. the e.i.r. does not analyze sutter's regionallization. sutter's business plan would entail ridding itself of 1,300 hospital beds in the bay area in a way that anticipates a transfer of patients between cities. cpmc's plan is part of the same business plan as sutter's operations all over the bay area and should be analyzed in terms of the cumulative effects of those plans. we encourage cpmc to come to the table and engage in a substantive dialogue around healthcare impacts, the size of st. luke's, jobs, affordable housing. but we really need an environmental impact review that looks at the healthcare impacts and it shouldn't be approved the way it is right now.

thank you. president miguel: thank you. [applause] please. it only takes up time. >> good afternoon, commissioners. my name is paul warmer and i'm here wearing heights of both pacific heights residence association and the neighbor's coalition which is a group that has worked with the pacific site facility since 2002 on planning the new activities as well as locate operational issues. i would start by saying something new which is that we do appreciate the outreach cpmc has begun to our neighborhood on plans for that site so with luck when the project level e.i.r. for that activity comes forward, we won't have so much to bicker about. there's been a lot of discussion about traffic. and the d.i.r. traffic and

circulation analysis is in fact significantly inadequate. it deals with the conventional sequa application of looking at commute traffic at peak hours. however, sequa does not say "thou shalt not consider other impacts." in fact, if you read the enabling legislation, it talks about quality of life as the driver and how the environment is important for a healthy quality of life. by the way, i'm not a lawyer. but i do try to read some of the source material to understand why something may be so. so the problem is, it looks only in many cases that the peak p.m. traffic. that's not when the worst impacts occur in many neighborhoods. the schools are letting out at about 3:00 p.m., there are peak traffic delivers at that time. the concerns in the tenderloin

with traffic in schools. increasing traffic outside of the peak p.m. period will have a direct impact on the residential environment. that's nod -- not considered in this document. the data used for the pacific site was comparing daily averages but you're comparing daily averageof visitors on a 24-hour operation to something that's moving to a daytime operation. very difficult to make sense out of that. it doesn't leave us comfortable and it's a data gap. the assessment of the bicycle and pedestrian impacts is inadequate. it looks at how pedestrians fit on the sidewalk, it doesn't look at the vehicle interaction with pedestrians. it's a big deal. and i want to touch on the three a plus. the services that were alluded to earlier both before and after care are significant. i have dealt with this in my family and i have dealt with the

discontinuity of care when people are turfed out of a hospital because they no longer need the in-hospital beds but are instead sent to a third-party skilled nursing facility. the continuity of care, continuity of documentation and communication between the medical staff is a disaster and causes great problems. that is another impact. thank you. president miguel: thank you. debby perkins. eileen trend will have, robert atchison, jane solen. >> good evening, my name is

eileen prendvil and i work with the pediatric i.c.u. we take care of the most fragile infants and children during their often long and protracted hospitalizations. we have a combined service of over 240 years at the california pacific medical center. we've seen a great deal of change in healthcare. we became nurses because we care about each other and we want to make a difference in people's lives in their time of need. we care passionately about our patients and our community especially when it comes to healthcare. one of our concerns is the size of this proposed hospital where all tertiary care would be

consolidated in one building. a huge hospital on van ness avenue would be disastrous after an earthquake. patients would have difficulty getting there as traffic would be gridlocked. i disagree with my co-worker neonatologist, but it wouldn't be the first time doctors and nurses disagree. now is the time to make sure that the healthcare needs of san franciscoans are met effectively as hospitals comply with the state's hospital seismic law. we urge you to make sure that cpmc scales down the size of cathedral hill and increases the services and size of st. luke's in order to make it a viable hospital to will provide equal

access to scare for all of our patients -- care for all of our patients and their families. thank you. president miguel: thank you. michael lyon, tony gazetta, jonathan brooks. >> good afternoon, commissioners. thank you for listening to all the testimony you've heard thus far. i'm sure you have another hour or two of it. i'm barbara and i've been working in the tenderloin the last five years with latino families. you heard testimony from some of our families. many of our families had to lead like the nurse before me said. 3:00 is pick-up hour and people must get there. i wanted to share one thought that one of the moms who wanted me to communicate to you. her name is bianca and lives at geary and larkin. she said the last week was the first time she heard about the hospital. i have to ask the hospital, what

has been the process cpmc reaching out to the community particularly in the multilingual fashion. many of our families, only one person had heard about the hospital. i also submitted a packet with the surveys and submitted a report from urban solutions indicating that the corridor has the highest incidence of latino families of all the tenderloino for me it's a serious concern that many of these families weren't noticed about the hospital and will be deeply impacted about the project. i want to go over what some of the survey says since i feel like cpmc has outreached to our community, i thought, we had a meeting on friday, let's find out what our families think about the hospital and what they think about this plan. i did a survey of the 26 folks that were there and this is the outcome because i don't know if this helps. of the 26 there, 20 live in the tenderloin, four live along the franklin corridor which is on

the other side. and 88% of the respondents that i talked to had either meddical or healthy kids so for me it's disconcerting to see the build of a hospital where 88% might not have access to it. they go to community clinics. when i asked what kind of hospital they'd like to see in the neighborhood, most said that hospital that serves needs of children, emergency services and dental services. the other thing is the traffic and contamination issue. before you've seen a million and one pedestrian reports in the tenderloin. it is one of the most dangerous areas to walk through and the highest density of children so for us it's disconcerting to see we'll have 10,000, 2,000 more cars coming through the area where we already have deaths. it's something that affects us

in the community. we see families hit by cars. the traffic thing is a serious issue, as is the pollution. the construction. a lot of our families live at that block on larken and geary. how is construction going to handle it and i don't think there's been an open and meaningful community process. we ask you to listen to what the tenderloin has to say. i think a lot of folks that came before you haven't been outreached to in a meaningful way and that will affect the relationship between the hospital and the community. a folks that came forward seem to be connected to cpmc in a financial way or another so that really bothers me. i think there's a lot of families. thank you for your time. president miguel: thank you. >> good afternoon. i'm jane sandoval, a staff nurse at st. luke's and have been a staff nurse for 25 years. i work in the emergency department and have been there for 15 years. three years ago cpmc announced

their plans to close st. luke's and this was to, in their words, provide a spectrum of services consistent with community needs. fast forward to 2010, three years later, i'm still speaking. we saved the hospital, so to speak, but i'm calling it a stay of execution because the current plan is doomed to fail. the storm of protest from the community and nurses and this is the same community that was thought to have needed the closure of st. luke's because that was the need of the community. and their masterplan. although cpmc has promised to keep st. luke's open, there are many concerns regarding the rebuild. first of all is their track record. i think many people have already testified to their track record and their followthrough or lack thereof. there has continued to be service cuts. it's already been mentioned the lack of psychiatric beds. the skilled nursing facility beds are in jeopardy and most recently, the dialysis services are slotted for closure.

bottom line, things that don't generate money are not inclusive in the spectrum of services. the current rebuild of the emergency department for the rebuild of st. luke's called for increased square footage but not necessarily emergency department beds. the plan for a psychiatric holding area is flawed. psychiatric patients need placement, not in a holding area. often patients stay up to 72 hours in the emergency department until their hold is exhausted or placement is found and often placement is not found. the emergency department continues to be full. often overflow from san francisco general and just fallout from of the economic slowdown. people are coming to the emergency rooms because it's the only place where they can receive care. also, concern is lack of labor peace at the hospital. it's an ongoing issue for the last three years, as well.

we, the members of the california nurse's association, unlike our counterparts who spoke earlier, cannot and will not agree to a contract that limits our patient advocacy. parity not only with the community of the underserved but also with the staff nurses of st. luke's is a common goal asked of cpmc as well as transparency. the ultimate patient advocacy we as nurses can do for our patients is to support an adequate sized full service st. luke's, not a downsized version which is not consistent with the community need. i believe the community need has been well addressed at today's hearing as well as the hearings over the last three years. thank you. president miguel: thank you. >> good late afternoon. i'm tony gazetta from the plumber's union local 38 in

san francisco. i'm a city resident, work down on market street. we've heard the concerns of a lot of the residents, being impacted by the cathedral hill and all of what cpmc is going to do. the residents near cathedral hill want more services of st. luke's. residents of st. luke's want nothing to do with the new hospital. they want the one they have. residents of the tenderloin have worries of increased traffic. i represent members of local 38, the plumbers and pipe fitter's union. we understand some of these concerns. mine as well as that of many of my brothers and sisters from the building trades is jobs. construction jobs which pay a wage which allow the workers to support their families. 40% of the membership of the building and construction trades in san francisco, many of whom are city residents, are unemployed or underemployed. employed workers spend money and fuel the local economy. the unemployment workers cannot afford more delays. i urge you to approve this

e.i.r. and get san francisco working again. thi. president miguel: thank you. >> good evening. my name isianicca brooks, i'm a registered nurse at the bedside at cpmc's hospital nursing floor, post acute services for over 15 years. we serve meddical, unsured, medicare, mostly those suffering from chronic or acute conditions requiring multiple i.v.s, complex dressings and intensive medical care for a few days up to six weeks or longer. i am concerned that the cpmc draft plans for the elderly and disabled only includes 38 beds. instead, cpmc has verbally committed to provide 62 community or campus-based beds. there is a difference in

community or campus-based and i have provided the commission an outline with the difference. only to see increased hospitalizations and deaths, and no one wants that. cpmc has stated that the two sniffs are not in the e.i.r. draft because they are working to develop a transitional model for homecare based care after hospital discharge to bridge the gap between hospital discharge and home. while good, this still speaks only to those people going home. what about the growing elderly population and chronic sniff bed shortage in san francisco that is estimated to be 30% over the next decade? what will happen if these vulnerable people are sent home too early or have to go outside of san francisco for care? it is well known in our facility that cpmc wants to close our unit and has wanted to for some time. from a business perspective, we serve a patient population that

is an income loser rather than a gainer. we would be closed now as documented in cpmc's prior plans and we have only remained open because community outrage that cpmc sutter would cut these services has caused cpmc to pause in their plans. i stand before you as a registered nurse with concerns over citywide healthcare for the elderly and disabled. these people should not be thrown under the bus in lieu of a new state-of-the-art hospital. i urge the commissioners to hold cpmc to continue with their studies over successful recovery at home but not to eliminate any skilled nursing beds in their final environmental report. thank you. president miguel: thank you. >> good afternoon. i'm a local 377 iron workers business representative representing over 2500 iron workers in the greater bay area

with many of them being san francisco residents. i'm here on behalf of those members to support cpmc's project. as you know, the construction industry has been hit especially hard in this recession and presently we have at least 1/3 of our members under employed or unemployed. this project would put a great many of them back to work as well as bring a state-of-the-art hospital facility downtown. as planning commissioners, i know you have a great many weighty issues to deal with in approving the draft e. i.r. but i hope you will consider the position impact you have on amendment in this community at a time -- employment in this community at a time when good paying jobs are particularly needed. i urge you to move the project forward as expeditiously as possible and help us to put our members as well as many other construction workers back to work. thank you miguel michigan thank- president miguel: thank you.

rosa marquez, linda chapman, patresia from new community employment report, linda harter and bruce hicks. prosecutoreer >> linda harkin. i'm here representing the van ness plan. for more than 20 years, it's been the guideline that's directed what's developed on van nes and what cpmc has proposed violates every objective of the

van ness plan. i also believe that a win-win solution is possible. probably, even though no hospital is supposed to be built there, no office buildings, nothing but housing with retail beneath, minimal retail, i believe that this is not a bad location for a hospital to replace an office building and a hotel provided that in other respects it follows the van ness plan. if it's going to completely violate the van ness plan with the height limit, with not producing housing, etset -- which is required of every developer at a ratio of 3 to 1 and of course will not be all located within the van ness area but could be located on many sites in the tenderloin or even south of market if they pay for that. otherwise, there is the no project alternative which means they can still build their hospital but they can build it on the campuses where it is instead of bringing it here.

now, this is a very well reasoned document. the reason for the 130 feet had to do with the land form. it gradually -- it graduates up from the water tower 130 feet. that allowed for development of housing but it didn't overwhelm the historic commercial buildings that are there, architecturally significant. it also would avoid producing a great deal of traffic on a street that is already, you know, at an impasse of traffic that would occur with either a great deal of highrise or office development or this development. it was determined this was the most important boulevard in san francisco besides market street, that it deserve they'd kind of consistent treatment and that in addition it was a perfect place for housing. it was near downtown, it was on transit, and there were a lot of in-fill spaces for that. so that's what we should have for the most part.

if they're going to build this here, we must consider the fact that van ness is prone to be completely tied up with traffic. how are these people who it's so important to get them all immediately to care, it took me two hours this winter to get from pine street to 22nd and the mission. how fast will people from the mission get over to the hospital? and that was only because it rained in the morning, you know. the bus driver said get off and walk to market and everybody did because the traffic was completely tied up. also, on other occasions, it is highway 101. that is a consideration, too. as well as being the local transit agency's major street and for the golden gate transit. i've ridden in on highway 101 when it's blocked up and people go down polk street and block up polk street. the whole area could be blocked up so we don't need extra

parking there which will only bring in more cars. even the alternative 3a or b, which is the downsize alternative, increases the parking on that location by one third and i think we should not increase the parking at all. there was a time when you had to have a minimum amount of parking but even with residences now, we're no longer doing one-for-one parking in all locations. we're considering the transit oriented policies which i just noticed in the paper the other day, mat is saying people should generally be using their cars in order to go grocery shopping or delivering their children to school or if you were very sick and needed to go to the hospital. when i say 3a, essentially i'm thinking, yes, pretty much, 3a is in the document. greening for our neighborhood. lots of housing in the areas that need it and also maybe they need to consider distributing some of these wases like the

maternity services around to various hospitals rather than putting it all on one site. i will conclude by saying that yes, they've been doing community outreach and they've done with lower polk neighbors but the other night they came to lower polk neighbors and heard many concerns about impacts on traffic on, retail, and on noise, and then they told everybody not to come here. they convinced everyone not to come because they would have to sit in the overflow room and they would be better off watching it on television at home. is that community outreach as you understand it? they email me only to tell me come and support us but they don't email us when they're doing a presentation. president miguel: thank you. kyle bronson, allen lucy